Pengaruh Pemberian Vitamin D Terhadap Perbaikan Foto Toraks Pada Pasien TB Paru Etnik Batak Di Kota Medan Dihubungkan Dengan Polimorfisme ApaI Gen Reseptor Vitamin D
5
ABSTRAK
TB Paru merupakan salah satu masalah kesehatan di Asia Tenggara dan
Indonesia. Indonesia menduduki negara urutan kelima penderita TB paru di dunia.
Berdasarkan hasil penelitian sebelumnya ternyata ada perbedaan polimorfisme gen
sangat mempengaruhi kerentanan seseorang terhadap M. Tuberculosis pada budaya,
etnik dan populasi yang berbeda. Peranan polimorfsime gen RVD Apa1 dengan
pemberian vitamin D yang cukup mampu merespon cathelicidin untuk membantu
makrofag menekan pertumbuhan M. tuberculosis melalui peningkatan kadar
cathelicidin intraseluler.
Penelitian ini bertujuan untuk mengetahui pengaruh vitamin D terhadap
perbaikan foto toraks pada penderita TB paru etnik Batak dihubungkan dengan
polimorfisme gen RVD Apa1. Penelitian ini menggunakan metode design blinded
randomized controlled trial. Penelitian dilakukan di Puskesmas wilayah kota Medan
terhadap 42 pasien penderita TB paru yang memiliki polimorfisme gen RVD Apa
dengan etnik Batak, kelompok vitamin D 21 orang dan plasebo 21 orang.
Pemberian vitamin D dengan dosis 2,5 mg (100.000 IU) selama 4 kali
(minggu 0, 2, 4, 6). Polimorfisme gen RVD dianalisa menggunakan tehnik PCRRFLP. Hasil adalah frekuensi genotip AA 1 (4.8%), Aa 8 (38.1%) dan aa 12
(57.1%), pada kelompok intervensi vitamin D, AA 3 (14.3%), Aa 7 (33.3%) dan aa
11 (52.4%) pada kelompok yang diberikan plasebo. Terdapat perbedaan bermakna
kadar vitamin D sebelum dan sesudah perlakuan. Hasil pada kelompok vitamin D
p=0.00, perbedaan rerata kadar vitamin D 29,27+22 ng/ml, sedangkan kelompok
plasebo p=0.27, perbedaan rerata kadar vitamin D 1.36+5.53ng/ml. Perbaikan foto
toraks dianalisa dari hasil foto toraks paru sebelum dan sesudah perlakuan. Hasil pada
kelompok vitamin D (66,7%), sedangkan pada kelompok plasebo (33,3%).
Hubungan polimorfisme dengan perbaikan foto toraks dianalisa dan hasilnya tidak
terdapat hubungan perbaikan foto toraks dengan polimorfisme, p=1.000.
Kesimpulan pada populasi Indonesia etnik Batak tidak ada pengaruh antara
polimorfisme ApaI gen RVD terhadap perbaikan foto thoraks. Pada pemberian
vitamin D terdapat perbedaan bermakna kadar vitamin D sebelum dan sesudah
perlakuan.
Kata Kunci: Kadar Vitamin D, Perbaikan Foto Thoraks, Polimorfisme ApaI
Universitas Sumatera Utara
6
ABSTRACT
Pulmonary tuberculosis is one of health problems in Southeastern Asia and
Indonesia. Indonesia occupied the country fifth TB patients the in the world. Based
on the previous studies whether there are differences polymorphism genes affected
susceptibility of someone to M. Tuberculosis in culture, ethnic and different
population. The contribution of polimorfsime genes RVD Apa1 by the provision of
enough vitamin D able to respond to cathelicidin to help macrophages reduce M.
tuberculosis growth through elevated levels of cathelicidin intracellular.
The objective of the research was to analyze the influence of vitamin D on
improvement photo thoracic of Bataknese patients pulmonary tuberculosis was
connected to polymorphism genes RVD Apa1. This research used design blinded
randomized controlled trial method. The research was did at Public Health Center in
Medan to 42 Bataknese patients pulmonary tuberculosis with polymorphism genes
RVD Apa1, group was given vitamin D was 21 patients and plasebo was 21 patients.
The provision of vitamin D by a dose of 2.5 mg (100.000 IU) for 4 times
(weekly 0, 2, 4, 6). Polymorphism RVD genes were analysed using PCR-RFLP
technic. The result was the frequency of genotip AA 1 (4.8%), Aa 8 (38.1%) and aa
12 (57.1%), in the group was given vitamin D; AA 3 (14.3%), Aa 7 (33.3%) and aa
11 (52.4%) in the group was given placebo. There was significant influence of levels
of vitamin D before and after treatment. The results was the group was given vitamin
D p = 0.00, the difference average levels of vitamin D 29,27+22 ng/ml, while the
group was given placebo p = 0.27, the difference average levels of vitamin D
1.36+5.53ng/ml. Improvement thoracic photos was analysed from the results of a
photograph of the thoracic pulmonary before and after treatment. The results was in
group was given vitamin D (66.7%), while in group was given placebo (33.3%).
Relationship between Polymorphism and improvement thoracic photos was analysed
and there was no relationship improvement thoracic photo and polymorphism, p =
1,000.
The conclution of the research was showed the indonesian population ethnic
batak there was no significant influence Polymorphism RVD genes on improvement
thoracic photo. In the provision of vitamin D there was difference meaningful levels
of vitamin D before and after treatment.
Keywords : Levels of Vitamin D, Improvement Photo Thoracic, Polymorphism
ApaI
Universitas Sumatera Utara
ABSTRAK
TB Paru merupakan salah satu masalah kesehatan di Asia Tenggara dan
Indonesia. Indonesia menduduki negara urutan kelima penderita TB paru di dunia.
Berdasarkan hasil penelitian sebelumnya ternyata ada perbedaan polimorfisme gen
sangat mempengaruhi kerentanan seseorang terhadap M. Tuberculosis pada budaya,
etnik dan populasi yang berbeda. Peranan polimorfsime gen RVD Apa1 dengan
pemberian vitamin D yang cukup mampu merespon cathelicidin untuk membantu
makrofag menekan pertumbuhan M. tuberculosis melalui peningkatan kadar
cathelicidin intraseluler.
Penelitian ini bertujuan untuk mengetahui pengaruh vitamin D terhadap
perbaikan foto toraks pada penderita TB paru etnik Batak dihubungkan dengan
polimorfisme gen RVD Apa1. Penelitian ini menggunakan metode design blinded
randomized controlled trial. Penelitian dilakukan di Puskesmas wilayah kota Medan
terhadap 42 pasien penderita TB paru yang memiliki polimorfisme gen RVD Apa
dengan etnik Batak, kelompok vitamin D 21 orang dan plasebo 21 orang.
Pemberian vitamin D dengan dosis 2,5 mg (100.000 IU) selama 4 kali
(minggu 0, 2, 4, 6). Polimorfisme gen RVD dianalisa menggunakan tehnik PCRRFLP. Hasil adalah frekuensi genotip AA 1 (4.8%), Aa 8 (38.1%) dan aa 12
(57.1%), pada kelompok intervensi vitamin D, AA 3 (14.3%), Aa 7 (33.3%) dan aa
11 (52.4%) pada kelompok yang diberikan plasebo. Terdapat perbedaan bermakna
kadar vitamin D sebelum dan sesudah perlakuan. Hasil pada kelompok vitamin D
p=0.00, perbedaan rerata kadar vitamin D 29,27+22 ng/ml, sedangkan kelompok
plasebo p=0.27, perbedaan rerata kadar vitamin D 1.36+5.53ng/ml. Perbaikan foto
toraks dianalisa dari hasil foto toraks paru sebelum dan sesudah perlakuan. Hasil pada
kelompok vitamin D (66,7%), sedangkan pada kelompok plasebo (33,3%).
Hubungan polimorfisme dengan perbaikan foto toraks dianalisa dan hasilnya tidak
terdapat hubungan perbaikan foto toraks dengan polimorfisme, p=1.000.
Kesimpulan pada populasi Indonesia etnik Batak tidak ada pengaruh antara
polimorfisme ApaI gen RVD terhadap perbaikan foto thoraks. Pada pemberian
vitamin D terdapat perbedaan bermakna kadar vitamin D sebelum dan sesudah
perlakuan.
Kata Kunci: Kadar Vitamin D, Perbaikan Foto Thoraks, Polimorfisme ApaI
Universitas Sumatera Utara
6
ABSTRACT
Pulmonary tuberculosis is one of health problems in Southeastern Asia and
Indonesia. Indonesia occupied the country fifth TB patients the in the world. Based
on the previous studies whether there are differences polymorphism genes affected
susceptibility of someone to M. Tuberculosis in culture, ethnic and different
population. The contribution of polimorfsime genes RVD Apa1 by the provision of
enough vitamin D able to respond to cathelicidin to help macrophages reduce M.
tuberculosis growth through elevated levels of cathelicidin intracellular.
The objective of the research was to analyze the influence of vitamin D on
improvement photo thoracic of Bataknese patients pulmonary tuberculosis was
connected to polymorphism genes RVD Apa1. This research used design blinded
randomized controlled trial method. The research was did at Public Health Center in
Medan to 42 Bataknese patients pulmonary tuberculosis with polymorphism genes
RVD Apa1, group was given vitamin D was 21 patients and plasebo was 21 patients.
The provision of vitamin D by a dose of 2.5 mg (100.000 IU) for 4 times
(weekly 0, 2, 4, 6). Polymorphism RVD genes were analysed using PCR-RFLP
technic. The result was the frequency of genotip AA 1 (4.8%), Aa 8 (38.1%) and aa
12 (57.1%), in the group was given vitamin D; AA 3 (14.3%), Aa 7 (33.3%) and aa
11 (52.4%) in the group was given placebo. There was significant influence of levels
of vitamin D before and after treatment. The results was the group was given vitamin
D p = 0.00, the difference average levels of vitamin D 29,27+22 ng/ml, while the
group was given placebo p = 0.27, the difference average levels of vitamin D
1.36+5.53ng/ml. Improvement thoracic photos was analysed from the results of a
photograph of the thoracic pulmonary before and after treatment. The results was in
group was given vitamin D (66.7%), while in group was given placebo (33.3%).
Relationship between Polymorphism and improvement thoracic photos was analysed
and there was no relationship improvement thoracic photo and polymorphism, p =
1,000.
The conclution of the research was showed the indonesian population ethnic
batak there was no significant influence Polymorphism RVD genes on improvement
thoracic photo. In the provision of vitamin D there was difference meaningful levels
of vitamin D before and after treatment.
Keywords : Levels of Vitamin D, Improvement Photo Thoracic, Polymorphism
ApaI
Universitas Sumatera Utara